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Introduction <p>To evaluate whether lateral decubitus positioning increases the pleura–plexus distance at the supraclavicular level and to characterize its role as a modifiable anatomical factor relevant to ultrasound-guided interventions.</p> Methods <p>This prospective observational ultrasound study included 90 adults comprising individuals with complex regional pain syndrome, cervical spine stenosis, and healthy controls. Pleura–plexus distance was measured at end expiration in three standardized positions: semi-reclined supine, 45° lateral tilt, and lateral decubitus. Positional effects were assessed using mixed repeated-measures analysis of variance, and associations with demographic variables were examined using correlation and multivariable linear regression.</p> Results <p>Pleura–plexus distance increased progressively across positions in all groups. Compared with the semi-reclined position (0.37–0.46&#xa0;cm), lateral decubitus positioning more than doubled the distance (0.82–1.04&#xa0;cm; <i>p</i> &lt; 0.001), with a significant group interaction. Body mass index independently predicted pleura–plexus distance in the lateral position (+0.028&#xa0;cm per kg/m<sup>2</sup>, <i>p</i> &lt; 0.001), whereas age was not significantly associated.</p> Conclusions <p>Lateral decubitus positioning was consistently associated with increased pleura–plexus distance at the supraclavicular level across all study groups. These findings suggest that patient positioning represents a measurable and potentially modifiable anatomical factor that may influence anatomical conditions relevant to ultrasound-guided supraclavicular procedures.</p>

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Lateral Decubitus Positioning Increases Pleura–Plexus Distance in Ultrasound-Guided Supraclavicular Brachial Plexus Targeting

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月27日

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  • Carl P. C. Chen,
  • Areerat Suputtitada

摘要

Introduction

To evaluate whether lateral decubitus positioning increases the pleura–plexus distance at the supraclavicular level and to characterize its role as a modifiable anatomical factor relevant to ultrasound-guided interventions.

Methods

This prospective observational ultrasound study included 90 adults comprising individuals with complex regional pain syndrome, cervical spine stenosis, and healthy controls. Pleura–plexus distance was measured at end expiration in three standardized positions: semi-reclined supine, 45° lateral tilt, and lateral decubitus. Positional effects were assessed using mixed repeated-measures analysis of variance, and associations with demographic variables were examined using correlation and multivariable linear regression.

Results

Pleura–plexus distance increased progressively across positions in all groups. Compared with the semi-reclined position (0.37–0.46 cm), lateral decubitus positioning more than doubled the distance (0.82–1.04 cm; p < 0.001), with a significant group interaction. Body mass index independently predicted pleura–plexus distance in the lateral position (+0.028 cm per kg/m2, p < 0.001), whereas age was not significantly associated.

Conclusions

Lateral decubitus positioning was consistently associated with increased pleura–plexus distance at the supraclavicular level across all study groups. These findings suggest that patient positioning represents a measurable and potentially modifiable anatomical factor that may influence anatomical conditions relevant to ultrasound-guided supraclavicular procedures.